Human Anatomy - University of Florida



Human Anatomy

Abdominal Organs

Abdominal Esophagus

Innervation

Anterior & posterior gastric nerves = Left & right vagal trunks

Thoracic sympathetic trunks

Greater & Lesser splanchnic nerves

Esophageal nerve plexus

Arterial

Esophageal branches = left gastic artery = celiac trunk = aorta

Left inferior phrenic artery

Venous

Esophageal veins = azygos vein = inferior vena cava

Left gastric vein = splenic vein = portal vein

Lymphatic

Left gastric lymph nodes = celiac lymph nodes

TBTB

Retroperitoneal

Esophageal hiatus = T10

* Portal-systemic venous anastomosis

Stomach

Innervation

Anterior & posterior vagal trunks = parasympathetic (enter through esophageal hiatus)

Greater splanchnic nerve (T6-T9) in celiac plexus = sympathetic

Arterial

Left gastric artery = celiac trunk = aorta

Right gastric artery = common hepatic artery = celiac trunk = aorta

Short gastric arteries = splenic artery = celiac trunk = aorta

Left gastro-omental artery = splenic artery = celiac trunk = aorta

Right gastro-omental artery = gastroduodenal artery = common hepatic artery = celiac trunk = aorta

Venous

Left gastric vein = splenic vein = portal vein

Right gastric vein = portal vein

Short gastric vein = splenic vein = portal vein

Left gastro-omental = splenic vein = portal vein

Right gastro-omental = superior mesenteric vein = portal vein

Lymphatic

Gastric lymphatic vessels = gastric & gastro-omental lymph nodes = celiac lymph nodes

TBTB

Stomach bed

1. Pancreas

2. Left crus of diaphragm

3. Left kidney

4. Left suprarenal gland

SI: Duodenum

Innervation

Celiac & superior mesenteric plexuses = vagus & sympathetic fibers

Arterial

Superior pancreaticoduodenal artery (1st & 2nd part) = celiac trunk = aorta

Inferior pancreaticoduodenal artery (3rd & 4th part) = superior mesenteric artery = aorta

Venous

Pancreaticoduodenal veins = superior mesenteric vein = portal vein

Lymphatic

Pancreaticoduodenal lymph nodes & superior mesenteric lymph nodes = celiac lymph nodes

TBTB

L2 = duodenojejunal flexure = ligament of Treitz (diaphragm to duodenum)

SI: Jejunum & Illeum

Innervation

Perivascular nerve plexus

Sympathetic = T5-T9 of celiac and superior mesenteric plexus (Greater & lesser splanchnic)

Parasympathetic = posterior vagal trunk

Arterial

Vasa recta = arterial arcades = superior mesenteric artery

Venous

Superior mesenteric vein = portal vein

Lymphatic

Mesenteric lymph nodes = superior mesenteric lymph nodes

Ileocolic lymph nodes

TBTB

Vessels run between mesentery

Large Intestine

Innervation

Cecum & appendix = superior mesenteric plexus (vagus = parasympathetic)

Ascending colon = superior mesenteric plexus

Transverse colon = superior mesenteric plexus (vagus = parasympathetic)

Descending colon = lumbar sympathetic trunk (IMA plexus) & pelvic splanchnic

Sigmoid colon = superior hypogastric plexus (IMA plexus) & pelvic splanchnic

Rectum & anal canal = hypogastric plexus & pelvic splanchnic

Arterial

Cecum & appendix = ileocolic artery = superior mesenteric artery = aorta

Ascending colon = ileocolic & right colic arteries = superior mesenteric artery = aorta

Transverse colon = middle colic artery = superior mesenteric artery = aorta

Descending colon = left colic artery = inferior mesenteric artery = aorta

Sigmoid colon = sigmoid artery = inferior mesenteric artery = aorta

Rectum & anal canal = superior rectal artery = inferior mesenteric artery = aorta

Venous

Cecum & appendix = ileocolic vein = superior mesenteric vein = portal vein

Ascending colon = ileocolic & right colic veins = superior mesenteric vein = portal vein

Transverse colon = middle colic vein = superior mesenteric vein = portal vein

Descending colon = left colic vein = inferior mesenteric vein = splenic vein = portal vein

Sigmoid colon = sigmoid vein = inferior mesenteric vein = splenic vein = portal vein

Rectum & anal canal = superior rectal vein = inferior mesenteric vein = splenic vein = portal vein

Lymphatic

Cecum & appendix = ileocolic lymph nodes = superior mesenteric lymph nodes

Ascending colon = epicolic & paracolic lymph nodes = superior mesenteric lymph nodes

Transverse colon = middle colic lymph nodes = superior mesenteric lymph nodes

Descending colon = paracolic lymph nodes = inferior mesenteric lymph nodes

Sigmoid colon = paracolic lymph nodes = inferior mesenteric lymph nodes

Rectum & anal canal = inferior mesenteric lymph nodes

TBTB

Distinguishing features

1. Teniae coli = termination indicates rectosigmoid junction & base of appendix

2. Sacculations

3. Omental appendices

4. Caliber

Rectum

Innervation

Sympathetic = lumbar sympathetic trunk & superior hypogastric plexus (IMA)

Parasympathetic = pelvic splanchnic nerve (inferior hypogastric plexus)

Afferents = travel up lumbar splanchnic nerve

Arterial

Superior rectal artery = inferior mesenteric artery = aorta

Middle rectal artery = inferior vesical (male) or uterine (female) artery

Inferior rectal artery = internal pudendal artery = internal iliac artery = common iliac artery = aorta

Venous

Superior rectal veins = inferior mesenteric vein = splenic vein = portal vein

Middle rectal veins = IVC

Inferior rectal veins = IVC

Lymphatic

Superior half = pararectal lymph nodes = lumbar lymph nodes

Inferior half = internal iliac lymph nodes

TBTB

Rectosigmoid junction = S3

Rectal Examination by palpation

Prostate gland = male

Seminal glands = male

Cervix = female

Sacrum

Coccyx

Ischial spines

Ischial tuberosities

Enlarged internal iliac lymph nodes

Thicken ureters = pathology

Ischioanal fossae swelling

Inflamed appendix

Anal Canal

Innervation

Inferior hypogastric plexus = above pectinate line

Sympathetic & parasympathetic

Inferior rectal nerve (pudendal nerve) = below pectinate line

Arterial

Superior rectal artery = above pectinate line

Middle rectal artery = anatomose superior and inferior rectum

Inferior rectal artery = below pectinate line

Venous

Internal rectal venous plexus

Superior rectal vein = above pectinate line

Middle rectal vein = anatomose

Inferior rectal vein = below pectinate line

Lymphatic

Internal iliac lymph nodes = above pectinate line

Superficial inguinal lymph nodes = below pectinate line

TBTB

Anal columns

Anal sinuses

Anal valves

Spleen

Innervation

Celiac plexus = vasomotor

Arterial

Splenic artery = celiac trunk = aorta

Venous

Splenic vein = portal vein

Lymphatic

Splenic lymphatic vessels = pancreaticosplenic lymph nodes

TBTB

Gastrosplenic & splenorenal ligament

Pancreas

Innervation

Celiac plexus & superior mesenteric plexus = vagus (para) & thoracic splanchnic (sym)

Arterial

Pancreatic arteries = splenic artery = celiac trunk = aorta

Superior pancreaticoduodenal artery = gastroduodenal artery = celiac trunk = aorta

Inferior pancreaticoduodenal artery = superior mesenteric artery = aorta

Venous

Pancreatic branches = splenic vein = portal vein

Pancreaticoduodenal vein = superior mesenteric vein = portal vein

Lymphatic

Pancreaticosplenic nodes = celiac & hepatic & superior mesenteric lymph nodes

TBTB

Retroperitoneal

Major duodenal papilla = hepatopancreatic ampulla = pancreatic & bile duct

Gallbladder & Bile Duct

Innervation

Hepatic plexus = celiac plexus (sympathetic) & posterior vagal trunk (para) & right phrenic nerve (sensory)

Arterial

Posterior superior pancreaticoduodenal artery = gastroduodenal artery = c.h.a. = celiac trunk = aorta

Gastroduodenal artery = common hepatic artery = celiac trunk = aorta

Cystic artery = right hepatic artery = proper hepatic artery = common hepatic artery = celiac trunk = aorta

Right hepatic artery = proper hepatic artery = common hepatic artery = celiac trunk = aorta

Venous

Superior pancreaticoduodenal vein = portal vein

Cystic vein = portal vein

Lymphatic

Cystic lymph node = celiac lymph node

TBTB

Right epigastric region

Liver

Innervation

Hepatic nerve plexus = celiac nerve plexus (sympathetic) & vagal trunk (parasympathetic)

Greater splanchnic nerve

Arterial (receive blood)

Portal vein

Right & left hepatic artery = proper hepatic artery = common hepatic artery = celiac trunk = aorta

Venous (drain blood)

Hepatic vein

Lymphatic

Superficial lymphatics = hepatic lymph nodes = celiac lymph nodes = chyle cistern

Bare area = phrenic lymph nodes = posterior mediastinal lymph nodes

TBTB

Porta hepatis

1. Portal vein

2. Hepatic artery

3. Hepatic nerve plexus

4. Hepatic duct

5. Lymphatic vessels

Kidney

Innervation

Renal plexus = aorto-renal ganglia

Least splanchnic nerve

CN X

Arterial

Renal arteries (L1-L2) = aorta

Venous

Left & Right renal vein = inferior vena cava

Lymphatic

Lumbar lymph nodes

TBTB

Renal vein (anterior) – renal artery (middle) – renal pelvis (posterior)

Suprarenal Glands

Innervation

Renal plexus = celiac plexus

Splanchnic nerve = chromaffin cells (medulla only)

No parasympathetic

No innervation to supra-renal cortex

Arterial

Superior suprarenal artery = inferior phrenic artery = aorta

Middle suprarenal artery = aorta

Inferior suprarenal artery = renal artery = aorta

Venous

Left suprarenal vein = left renal vein = inferior vena cava

Right suprarenal vein = inferior vena cava

Lymphatic

Lumbar lymph nodes

TBTB

Testis

Innervation

Testicular plexus of nerves (autonomic) = on testicular artery

- Vagal parasympathetic & sympathetic

T7 visceral afferent of spinal cord

Arterial

Testicular artery (in spermatic cord) = branch of aorta

Venous

Testicular veins = form pampiniform plexus

Lymphatic

Lumbar & preaortic lymph nodes

TBTB

Constituents of spermatic cord

1. Ductus deferens = sperm from epididymis

2. Testicular artery = supply testis and epididymis

3. Artery of ductus deferens

4. Cremasteric artery = from inferior epigastic artery

5. Pampiniform plexus

6. Sympathetic nerve fibers on arteries (sym & parasym on ductus deferens)

7. Genital branch of genitofemoral nerve = supply cremaster muscle

8. Lymphatic vessels = to lumbar & preaortic lymph nodes

Ureters

Innervation

T11-L1 or L2

Arterial

Female = uterine artery = common & internal iliac = aorta

Male = inferior vesical artery =common & internal iliac = aorta

Venous

Female = uterine vein

Male = inferior vesical vein

Lymphatic

Lumbar & common iliac lymph nodes

TBTB

Ureteric calculi = where external iliac artery cross ureter

Males = ductus deferens pass b/w ureter and peritoneum

Urinary Bladder

Innervation

Parasympathetic = pelvic splanchnic nerve

Sympathetic = T11-L2 of vesical nerve plexus = inferior hypogastric plexus

Arterial

Males

Superior vesical artery = internal iliac artery = aorta

Inferior vesical artery = internal iliac artery = aorta

Females

Superior vesical artery = internal iliac artery = aorta

Vaginal artery = uterine artery = internal iliac artery = aorta

Obturator & inferior gluteal artery = internal iliac artery = aorta

Venous

Vesical venous plexus = internal iliac vein

Lymphatic

External iliac lymph nodes

Internal iliac lymph nodes

TBTB

Extravasation = urine in retroperitoneal

Urethra

Innervation

Male

Pudendal nerve

Prostatic plexus

Female

Pudendal nerve

Afferents = pelvic splanchnic nerve

Arterial

Male

Inferior vesical & middle rectal artery = prostatic urethra

Internal pudendal artery = spongy (penile) urethra

Female

Internal pudendal artery

Vaginal artery

Venous

Male

Inferior vesical & middle rectal veins

Internal pudendal vein

Female

Internal pudendal vein

Vaginal vein

Lymphatic

Internal iliac lymph nodes

External iliac lymph nodes

TBTB

Straddle injury = spongy part of penis; urine leak into superficial perineal pouch

Portal-Caval Anastomoses

Esophageal

Azygos vein = systemic

Left gastric vein = portal

Paraumbilical

Superficial epigastric vein = systemic

Paraumbilical vein = portal

Colic

Retroperitoneal vein = systemic

Colic vein = portal

Rectal

Middle rectal vein = systemic

Inferior rectal vein = systemic

Superior rectal vein (superior mesenteric vein) = portal

Splanchnic Nerves

Sympathetic

Greater splanchnic = celiac ganglia

Stomach

Duodenum

Liver

Gall bladder

Pancreas

Spleen

Suprarenal gland (adrenal medulla)*

Lesser splanchnic = renal & superior mesenteric ganglia

Small intestine

Colon (up to hepatic flexure)

Pancreas

Kidneys

Suprarenal gland

Testes or ovaries

Least splanchnic = renal & superior mesenteric ganglia

Transverse colon (up to splenic flexure)

Kidneys

Suprarenal gland

Lumbar splanchnic = inferior mesenteric ganglia

Distal 1/3 transverse colon

Descending colon

Sigmoid colon

Rectum

Significant Vertebral Levels

T5-9 = Greater splanchnic nerve (sympathetic)

T8 = inferior vena cava hiatus (IVC + right phrenic nerve + lymphatics)

T10 = esophageal hiatus (esophagus + vagal trunks + esophageal branches of left gastric artery)

T12 = aorta hiatus (aorta + thoracic duct + azygos vein)

T12-L1 = celiac trunk

T12-L3 = left kidney (right kidney = ½ verterbra lower)

L1 = superior mesenteric artery + pancreas + medial arcuate ligament

L2 = deodenojejunal flexure + gonadal arteries + cisterna chyli

L3 = inferior mesenteric artery

L1-L3 = right & left crura

L4 = aortic bifurcation (common iliac arteries) + umbilicus

L5 = inferior vena cava bifurcation

S2-3 = rectosigmoid junction

* spleen = 9-11 ribs

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